Background rates of all-cause mortality, hospitalizations, and emergency department visits among nursing home residents in Ontario, Canada to inform COVID-19 vaccine safety assessments

Maria Sundaram; Sharifa Nasreen; Andrew Calzavara; Siyi He; Hannah Chung; Susan E Bronskill; Sarah A Buchan; Mina Tadrous; Peter Tanuseputro; Kumanan Wilson; Sarah Wilson; Jeffrey C Kwong; Canadian Immunization Research Network (CIRN) investigators

doi:10.1016/j.vaccine.2021.07.060

Background rates of all-cause mortality, hospitalizations, and emergency department visits among nursing home residents in Ontario, Canada to inform COVID-19 vaccine safety assessments

Vaccine. 2021 Aug 31;39(37):5265-5270. doi: 10.1016/j.vaccine.2021.07.060. Epub 2021 Jul 23.

Affiliations

¹ ICES, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
² ICES, Toronto, ON, Canada.
³ ICES, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Women's College Research Institute, Toronto, ON, Canada.
⁴ ICES, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Public Health Ontario, ON, Canada.
⁵ ICES, Toronto, ON, Canada; Women's College Research Institute, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
⁶ ICES, Toronto, ON, Canada; Department of Medicine, University of Ottawa and Bruyere and Ottawa Hospital Research Institutes, Ottawa, ON, Canada.
⁷ Department of Medicine, University of Ottawa and Bruyere and Ottawa Hospital Research Institutes, Ottawa, ON, Canada.
⁸ ICES, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Public Health Ontario, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; University Health Network, Toronto, ON, Canada. Electronic address: jeff.kwong@utoronto.ca.

Abstract

Background: Nursing home (NH) residents are prioritized for COVID-19 vaccination. We report monthly mortality, hospitalizations, and emergency department (ED) visit incidence rates (IRs) during 2010-2020 to provide context for COVID-19 vaccine safety assessments.

Methods: We observed outcomes among all NH residents in Ontario using administrative databases. IRs were calculated by month, sex, and age group. Comparisons between months were assessed using one-sample t-tests; comparisons by age and sex were assessed using chi-squared tests.

Results: From 2010 to 2019, there were 83,453 (SD: 652.4) NH residents per month, with an average of 2.3 (SD: 0.28) deaths, 3.1 (SD: 0.16) hospitalizations, and 3.6 (SD: 0.17) ED visits per 100 residents per month. From March to December 2020, mortality IRs were increased, but hospitalization and ED visit IRs were reduced (p < 0.05).

Conclusion: We identified consistent monthly mortality, hospitalization, and ED visit IRs during 2010-2019. Marked differences in these rates were observed during 2020, coinciding with the COVID-19 pandemic.

Keywords: Baseline rates; COVID-19 vaccine safety; Hospitalization; Long-term care; Mortality.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19 Vaccines* / adverse effects
COVID-19*
Emergency Service, Hospital
Hospitalization
Humans
Nursing Homes*
Ontario / epidemiology
Pandemics
SARS-CoV-2

Substances

COVID-19 Vaccines